Ten Cognitive Distortions Identified in CBT

CBT Identifies and Changes Twisted Thinking

The basis of cognitive behavior therapy (CBT) is identifying cognitive distortions, or "twisted thinking," This distorted thinking pattern causes negative feelings, which in turn can worsen an addiction.

Dr. ​David Burns, a pioneer in CBT, identifies ten forms of twisted thinking. Here is how to apply them to addiction. 

All-or-Nothing Thinking Leads to Relapse

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All-or-nothing thinking, or "black and white thinking," can easily lead to relapse

An example of how all-or-nothing thinking leads to relapse is given in the story, "How CBT helped Joan quit alcohol." Joan felt like a failure at getting sober. Every time she had a "slip-up," she would drink to intoxication the same night.

Overgeneralization Leads to Relapse

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Overgeneralization happens when you make a rule after a single event or a series of coincidences. The words "always" or "never" frequently appear in the sentence.

In "How CBT helped Ben quit gambling." Ben had inferred from a series of coincidences that seven was his lucky number and overgeneralized this to gambling situations involving the number seven, no matter how many times he lost.

Mental Filters Lead to Relapse

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A mental filter is an opposite overgeneralization, but with the same negative outcome. Instead of taking one small event and generalizing it inappropriately, the mental filter takes one small event and focuses on it exclusively, filtering out anything else. 

In "How CBT helped Nathan quit cocaine," he needed to use cocaine in social situations because he filtered out all the good social experiences he had without cocaine, and fixated on the times he had not been on cocaine and others had seemed bored by his company. 

Discounting the Positive Leads to Relapse

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Discounting the positive is a cognitive distortion that involves ignoring or invalidating good things that have happened to you.

In "How CBT helped Joel quit compulsive sex," Joel compulsively seduces then rejects strangers because he discounts all of the positive non-sexual human interactions he has each day, as they aren't as intense or pleasurable as having sex with a stranger.

Jumping to Conclusions Leads to Relapse

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There are two ways of jumping to conclusions:

  • mind reading, where you think someone is going to react in a particular way, or you believe someone is thinking things that they aren't
  • fortune-telling when you predict events will unfold in a particular way, often to avoid trying something difficult

In "How CBT helped Jamie quit heroin," Jamie engaged in fortune-telling when he believed that he wouldn't be able to stand life without heroin. In reality, he could and he did.

Magnification Leads to Relapse

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Magnification is exaggerating the importance of shortcomings, and problems while minimizing the importance of desirable qualities. A person addicted to pain medication might magnify the importance of eliminating all pain, and exaggerate how unbearable their pain.

In "How CBT Helped Ken Cut Down on Pain Meds," Ken spends his life savings looking for a pill to take away his pain and depression.

Emotional Reasoning Leads to Relapse

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Emotional reasoning is a way of judging yourself or your circumstances based on your emotions.

In "How CBT helped Jenna stop eating too much," Jenna used emotional reasoning to conclude that she was a worthless person, which in turn lead to binge eating.

"Should" Statements Lead to Relapse

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"Should" statements are self-defeating ways we talk to ourselves that emphasize unattainable standards. Then, when we fall short of our own ideas, we fail in our own eyes.

In "How CBT helped Cheryl Stop Spending Too Much," Cheryl became addicted to overspending on shoes, because she couldn't live up to her own high standards.

Labelling Leads to Relapse

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Labelling is a cognitive distortion that involves making a judgment about yourself or someone else as a person, rather than seeing their behavior as something the person did that does not define them as an individual.

In, "How CBT helped Shannon quit marijuana," Shannon labeled herself a bad person unable to fit into mainstream society.

Personalization and Blame Leads to Relapse

Personalization and blame is a cognitive distortion whereby you entirely blame yourself, or someone else, for a situation that in reality involved many factors.

In "How CBT helped Anna overcome sexual anorexia," Anna blamed herself for childhood abuse by her father, reasoning that if she hadn't led him on, it never would have happened (this is actually what her father had told her at the time).

Because she personalized the abuse, she grew up with a compulsive avoidance of sex, known as sexual anorexia.

Source: Burns, D., M.D. The Feeling Good Handbook. (Revised edition). New York: Penguin. 1999.

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